Rugers, Remingtons, and Reality: A Gun Lover's Plea for a Safer Second Amendment
Authors: Michael Rose
Journal: Annals of Internal Medicine (2022)

Ideas and OpinionsSeptember 2022Rugers, Remingtons, and Reality: A Gun Lover's Plea for a Safer Second AmendmentFREEMichael Rose, MD, MPHMichael Rose, MD, MPHDepartments of Medicine and Pediatrics, Johns Hopkins Medicine, Baltimore, Maryland (M.R.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M22-1792 Annals Author Insight Video - Michael Rose, MD, MPH In this video, Michael Rose, MD, MPH, offers additional insight into the article, "Rugers, Remingtons, and Reality: A Gun Lover's Plea for a Safer Second Amendment." (Duration 2:31) SectionsAboutVisual AbstractPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The year was 2003. It was an unseasonably warm September in rural North Dakota. My 12th birthday had arrived, an important one in my family. When my brother had turned 12, his present had been a gray and black Remington .22. In hunting families, a .22 is the next step up from a BB gun—a perfect learning rifle and a stride toward hunting with Dad. Based on the slender box my parents handed me, I was sure the tradition would continue. I ripped back the wrapping paper and saw the unmistakable red writing atop the white cardboard: “Ruger.” My heart leapt. A Ruger 10/22, the same model as Dad's. The only differences were that this one still had the factory grease coating the blue steel and there were no scratches on the walnut stock.The next gun Dad added to the family collection for me to use was a hand-me-down 12-gauge Savage pump. I shot my first clay pigeon, my first pheasant, and my first duck with that shotgun. Soon after, we added others. Grandpa's knees and heart had grown too weak for hunting, so he gifted us his Remington 870 Wingmaster, a workhorse of a shotgun polished from years of wear and WD-40. At 14, I saved up and pitched in to buy the deer rifle I'd been dreaming about: a Remington 700 chambered in .30/06. It has a stainless steel barrel, a black synthetic stock, butter-smooth bolt action, a crisp trigger, and a matted Leupold 3-9×40 scope with its signature gold ring seated atop. That fall, I used it to shoot my first whitetail, and it has accompanied me on trips to the woods since.All this is to say: I love guns.But in addition to being a gun owner, hunter, and native North Dakotan, I'm a physician who practices in the heart of Baltimore and has studied public health policy. I know how central gun ownership is to wide swaths of America, and I know the devastating impact of our lack of gun regulation. These realities need not be at odds. By partnering with gun owners and embracing the public health principle of harm reduction, we can craft a safer Second Amendment.Harm reduction, a strategy of making gun use safer within the bounds set by our culture and courts, starts by recognizing that gun ownership across America is here to stay. An estimated 30% of Americans own a gun, and most grew up around them (1). Since our nation's inception, gun ownership has been cherished, and in District of Columbia v. Heller and more recently in NYSRPA v. Bruen, the Supreme Court affirmed it as a constitutional right (2, 3).However, both Bruen and Heller maintain that gun rights can be regulated (2, 3), and the history of public health tells us that regulation allows for harm reduction. Without banning cars, we reduced motor vehicle deaths per vehicle mile by 90%, simply by making the cars, roads, drivers, and conditions safer (4). Hundreds of Americans are saved from an opioid overdose daily thanks to the reversal agent naloxone. Condoms and clean needles have spared millions from HIV, viral hepatitis, syphilis, and other infections. Countless heart attacks have been prevented by utilizing cholesterol-lowering statin medications, regardless of a patient's willingness to change their lifestyle.Harm reduction can work against gun violence, too. In fact, it already has. In response to Prohibition-era gang violence, machine guns and sawed-off shotguns were strictly regulated. They remain so today. More recently, we've expanded background checks, though not universally. We temporarily limited magazine capacities and banned assault weapons, but unfortunately we let those laws lapse—and, partly as a result, we are seeing an unconscionable increase in mass shootings (5).At the state level, there are even more impressive examples of harm-reducing regulations. Since the 1990s, California has passed a series of sensible gun laws—under both Republican and Democratic governors—that have transformed the state from one of the worst to one of the best in terms of gun safety (6). Almost all of California's efforts have been upheld in court. None have threatened law-abiding citizens' ability to own a firearm. Given that guns can cross state borders, federal action offers even greater potential for protection, especially for smaller states.But is progress doomed nationally by the political power of gun owners? Not necessarily. Public discourse has become purposefully polarized by extremist groups like the National Rifle Association, yet in reality, they represent only a small fraction of the approximately 80 million Americans who own guns (1). More representative data show that the average gun owner holds far less extreme views (1, 7, 8). Bringing together gun owners and public health policymakers to advance new regulations is the best way forward.There are several popular policy proposals—all grounded in harm reduction—that would allow lawmakers to build a safer Second Amendment. To reduce the risk for mass killings, we can reinstate the national ban on assault weapons and high-capacity magazines; subject assault weapons in circulation to the enhanced restrictions faced by machine guns; and outlaw gun carrying in high-occupancy locations, such as malls, public transit, schools, and event venues.To curb homicides and suicides, we can implement universal background checks (including checks on guns gifted within families like mine); improved safety training; red flag laws allowing removal of guns from high-risk households; and laws preventing sales to violent criminals, domestic assailants, and people with severe mental illness (9). These policies have previously held up in court, will save lives, and enjoy broad support from gun owners (1, 7, 8).The extremist minority of gun owners are sure to raise their voices in opposition to any safety measures, but responsible gun owners can kindly remind them that they are the outliers, not us. We know that passing sensible laws won't endanger our factory-fresh .22s, hand-me-down shotguns, and trusty deer rifles. But they will reduce the unacceptable violence happening every day.References1. Parker K, Horowitz JM, Igielnik R, et al. The demographics of gun ownership. Pew Research Center. 22 June 2017. Accessed at www.pewresearch.org/social-trends/2017/06/22/the-demographics-of-gun-ownership on 20 July 2022. Google Scholar2. District of Columbia v Heller, 554 US 570 (2008). Google Scholar3. New York State Rifle & Pistol Association Inc. v Bruen, 597 US _ (2022). Google Scholar4. Centers for Disease Control and Prevention (CDC). Motor-vehicle safety: a 20th century public health achievement. MMWR Morb Mortal Wkly Rep. 1999;48:369-74. [PMID: 10369577] MedlineGoogle Scholar5. Koper CS. Assessing the potential to reduce deaths and injuries from mass shootings through restrictions on assault weapons and other high-capacity semiautomatic firearms. Criminol Public Policy. 2020;19:147-70. doi:10.1111/1745-9133.12485 CrossrefGoogle Scholar6. Dix G, Lieb L. Report: Trends in California Firearm Mortality Compared to the Rest of the U.S. Brady Campaign to Prevent Gun Violence. 14 October 2019. Accessed at https://ca.bradyunited.org/news/report-trends-in-california-firearm-mortality-compared-to-the-rest-of-the-u-s on 20 July 2022. Google Scholar7. Barry CL, Webster DW, Stone E, et al. Public support for gun violence prevention policies among gun owners and non-gun owners in 2017. Am J Public Health. 2018;108:878-81. [PMID: 29771617] doi:10.2105/AJPH.2018.304432 CrossrefMedlineGoogle Scholar8. American Public Media Research Lab Staff. APM Survey: Americans' Views on Key Gun Policies. Part One: Opinions on “Red Flag” Laws. 20 August 2019. Accessed at www.apmresearchlab.org/gun-survey-red-flag on 20 July 2022. Google Scholar9. Fleegler EW, Lee LK, Monuteaux MC, et al. Firearm legislation and firearm-related fatalities in the United States. JAMA Intern Med. 2013;173:732-40. [PMID: 23467753] doi:10.1001/jamainternmed.2013.1286 CrossrefMedlineGoogle Scholar Comments0 CommentsSign In to Submit A Comment Peter Scivoletti, MDprivate internal medical practice29 August 2022 When will it end? Your presentation is a reasonable, thoughful discussion on a problem which has fired up everyone on each side of the question, to accept as an answer to this problem an all or not result. Either we totally eliminate gun owership or we allow uncontrolled ownership of any kind of weapon. Each response is wrong. If we stopped the use of machine guns and sawed off shotguns, why can't we prohibit the sale of AK47s and ghost guns or any gun of mass destruction? It makes no sense that these types of weapons should be available to the general public. The fear that once one type of gun is controlled then in short order more and more will be restricted is very short sighted at best and I believe wrong. How many lives of innocent people will have to be sacrificed before we come to our senses? Political rhetoric on either side of this issue should be more reasoned. Where can we find the leaders of our goverment to do so? Will it take the loss of a Senator's son or a congressman's daughter or grand child to get this reasonable discussion started, I hate to think so but maybe that is what might be needed. In the meantime, we all must pray to our God that this will end and before anyone of us is at the end of a shooter's gun. Disclosures: IM Author, Article, and Disclosure InformationAffiliations: Departments of Medicine and Pediatrics, Johns Hopkins Medicine, Baltimore, Maryland (M.R.).Acknowledgment: The author thanks Benjamin Mazer, MD, MBA, and David Hemenway, PhD, for their expert editing and feedback on earlier drafts of the manuscript.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M22-1792.Corresponding Author: Michael Rose, MD, MPH, Departments of Medicine and Pediatrics, Johns Hopkins Medicine, 601 North Caroline Street, Baltimore, MD 21287; e-mail, [email protected]edu.Author Contributions: Drafting of the article: M. Rose.Critical revision for important intellectual content: M. Rose.Final approval of the article: M. Rose.This article was published at Annals.org on 30 August 2022. PreviousarticleNextarticle Advertisement Annals Author Insight Video - Michael Rose, MD, MPH In this video, Michael Rose, MD, MPH, offers additional insight into the article, "Rugers, Remingtons, and Reality: A Gun Lover's Plea for a Safer Second Amendment." (Duration 2:31) FiguresReferencesRelatedDetails Metrics September 2022Volume 175, Issue 9Page: 1326-1327KeywordsFirearm injuriesPrevention, policy, and public health ePublished: 30 August 2022 Issue Published: September 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...